ABSTRACT
BACKGROUND: Several treatments have been shown to prolong survival in metastatic castrate-resistant prostate cancer (mCRPC); the optimum sequencing of these is not established. We investigated methods of identifying patients with mCRPC unlikely to respond to abiraterone. PATIENTS AND METHODS: A retrospective analysis was carried-out in 47 consecutive patients with mCRPC treated sequentially with androgen deprivation (LHRHa), bicalutamide, docetaxel then abiraterone. RESULTS: The median progression-free survival in patients treated with abiraterone was shorter in those with ≤18 months' response to LHRHa (118 vs. 279 days; p=0.018), bicalutamide non-responders (91 vs. 196 days; p=0.003) and patients with ≤6 months' response to docetaxel (102 vs. 294 days; p<0.001). The median overall survival was also shorter (348 vs. 815 days, p=0.016; 413 vs. 752 days, p=0.009; and 325 vs. 727 days, p<0.04, respectively). CONCLUSION: A response of ≤18 months' to LHRHa, non-response to bicalutamide and ≤6 months' response to docetaxel predicted poor response to abiraterone.
